Potential alternative progestin therapy for low-grade endometrial stromal sarcoma: A case report

Area of Science:

• Gynecologic Oncology
• Medical Oncology
• Pharmacology

Background:

• Low-grade endometrial stromal sarcoma (LG-ESS) is a rare uterine malignancy with potential for recurrence and metastasis.
• Hormonal therapies, including progestins and aromatase inhibitors (AIs), are standard treatments for LG-ESS, often requiring long-term administration.
• Long-term use of high-dose progestins and AIs can lead to adverse effects such as thromboembolism and musculoskeletal pain.

Observation:

• A young patient with recurrent and metastatic LG-ESS demonstrated resistance to high-dose medroxyprogesterone acetate (MPA).
• This patient was treated with dienogest, a newer progestin with a reported favorable long-term safety profile.
• Dienogest monotherapy was administered to the patient with MPA-resistant LG-ESS.

Findings:

• Dienogest monotherapy was effective in treating the recurrent and metastatic LG-ESS.
• This represents the first report of dienogest efficacy in LG-ESS cases resistant to MPA and other hormonal agents.
• The patient achieved successful treatment outcomes with dienogest.

Implications:

• Dienogest may offer a safer and effective long-term treatment option for recurrent and metastatic LG-ESS, particularly in cases of hormonal therapy resistance.
• This finding could expand treatment strategies for patients with advanced or refractory LG-ESS.
• Further research into dienogest's role in managing LG-ESS is warranted to confirm its long-term efficacy and safety profile.